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Who gets to be first in line for a COVID-19 vaccine? U.S. health authorities hope by late next month to have some draft guidance on how to ration initial doses, but it’s a vexing decision.“Not everybody’s going to like the answer,” Dr. Francis Collins, director of the National Institutes of Health, recently told one of the advisory groups the government asked to help decide. “There will be many people who feel that they should have been at the top of the list.”Traditionally, first in line for a scarce vaccine are health workers and the people most vulnerable to the targeted infection.But Collins tossed new ideas into the mix: Consider geography and give priority to people where an outbreak is hitting hardest.And don’t forget volunteers in the final stage of vaccine testing who get dummy shots, the comparison group needed to tell if the real shots truly work.“We owe them ... some special priority,” Collins said.Huge studies this summer aim to prove which of several experimental COVID-19 vaccines are safe and effective. Moderna Inc. and Pfizer Inc. began tests last week that eventually will include 30,000 volunteers each; in the next few months, equally large calls for volunteers will go out to test shots made by AstraZeneca, Johnson & Johnson and Novavax. And some vaccines made in China are in smaller late-stage studies in other countries.For all the promises of the U.S. stockpiling millions of doses, the hard truth: Even if a vaccine is declared safe and effective by year’s end, there won’t be enough for everyone who wants it right away -- especially as most potential vaccines require two doses.It’s a global dilemma. The World Health Organization is grappling with the same who-goes-first question as it tries to ensure vaccines are fairly distributed to poor countries -- decisions made even harder as wealthy nations corner the market for the first doses.In the U.S., the Advisory Committee on Immunization Practices, a group established by the Centers for Disease Control and Prevention, is supposed to recommend who to vaccinate and when -- advice that the government almost always follows.But a COVID-19 vaccine decision is so tricky that this time around, ethicists and vaccine experts from the National Academy of Medicine, chartered by Congress to advise the government, are being asked to weigh in, too.Setting priorities will require “creative, moral common sense,” said Bill Foege, who devised the vaccination strategy that led to global eradication of smallpox. Foege is co-leading the academy’s deliberations, calling it “both this opportunity and this burden.”With vaccine misinformation abounding and fears that politics might intrude, CDC Director Robert Redfield said the public must see vaccine allocation as “equitable, fair and transparent.”How to decide? The CDC’s opening suggestion: First vaccinate 12 million of the most critical health, national security and other essential workers. Next would be 110 million people at high risk from the coronavirus -- those over 65 who live in long-term care facilities, or those of any age who are in poor health -- or who also are deemed essential workers. The general population would come later.CDC’s vaccine advisers wanted to know who’s really essential. “I wouldn’t consider myself a critical health care worker,” admitted Dr. Peter Szilagyi, a pediatrician at the University of California, Los Angeles.Indeed, the risks for health workers today are far different than in the pandemic’s early days. Now, health workers in COVID-19 treatment units often are the best protected; others may be more at risk, committee members noted.Beyond the health and security fields, does “essential” mean poultry plant workers or schoolteachers? And what if the vaccine doesn’t work as well among vulnerable populations as among younger, healthier people? It’s a real worry, given that older people’s immune systems don’t rev up as well to flu vaccine.With Black, Latino and Native American populations disproportionately hit by the coronavirus, failing to address that diversity means “whatever comes out of our group will be looked at very suspiciously,” said ACIP chairman Dr. Jose Romero, Arkansas’ interim health secretary.Consider the urban poor who live in crowded conditions, have less access to health care and can’t work from home like more privileged Americans, added Dr. Sharon Frey of St. Louis University.And it may be worth vaccinating entire families rather than trying to single out just one high-risk person in a household, said Dr. Henry Bernstein of Northwell Health.Whoever gets to go first, a mass vaccination campaign while people are supposed to be keeping their distance is a tall order. During the 2009 swine flu pandemic, families waited in long lines in parking lots and at health departments when their turn came up, crowding that authorities know they must avoid this time around.Operation Warp Speed, the Trump administration’s effort to speed vaccine manufacturing and distribution, is working out how to rapidly transport the right number of doses to wherever vaccinations are set to occur.Drive-through vaccinations, pop-up clinics and other innovative ideas are all on the table, said CDC’s Dr. Nancy Messonnier.As soon as a vaccine is declared effective, “we want to be able the next day, frankly, to start these programs,” Messonnier said. “It’s a long road.”___The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. 5581

Will the iPhone X change your life for the better and usher you into the future, face first? Or is it just another smartphone with a giant screen and a strange little rectangle on top?We've only had the phone since Monday morning. It's more than the few minutes of hands-on time reporters had when the device was launched, but a day is not enough time to fairly review the iPhone X. It's like deciding if you want to marry someone after one blind date.So while we test, tinker and tap this week, here are some first impressions to whet your appetite, presented as yearbook superlatives: 594

White House senior adviser Jared Kushner called for unity Monday at the opening of the United States' new embassy in Jerusalem, according to excerpts of his speech released by the White House."We believe, it is possible for both sides to gain more than they give -- so that all people can live in peace -- safe from danger, free from fear, and able to pursue their dreams."Jerusalem must remain a city that brings people of all faiths together," Kushner said.The senior adviser's speech comes after at least 41 people were killed during clashes earlier in the day along the border fence between Israel and Gaza, the most fatalities suffered in a single day since the latest round of demonstrations began more than six weeks ago.Kushner also praised to praise President Donald Trump's efforts to move the US embassy to Jerusalem."While presidents before him have backed down from their pledge to move the American Embassy once they were in office, this President delivered. Because when President Trump makes a promise, he keeps it," Kushner stated.Kushner, who is also the President's son-in-law, has been leading efforts to broker an Israeli-Palestinian peace proposal, though any accord would be colored by the administration's recognition of Jerusalem as Israel's capital and decision to move the US embassy there from Tel Aviv.During his speech, Kushner is also expected to praise Israel as a country that "proves every day the boundless power of freedom.""This land is the only land in the Middle East in which Jews, Muslims, and Christians, and people of all faiths participate and worship freely according to their beliefs," Kushner said. "Israel protects women's rights, freedom of speech, and the right of every individual to reach their God-given potential."Kushner is also remarked on Iran, calling it "flawed" and "one-sided" less than a week after Trump's decision to withdraw from the Iran nuclear deal."Iran's aggression threatens the many peace-loving citizens throughout the region and the world," Kushner said. "From Israel to Jordan to Egypt to Saudi Arabia and beyond, many leaders are fighting to modernize their countries and create better lives for their people. In confronting common threats, and in pursuit of common interests, previously unimaginable opportunities and alliances are starting to emerge."Kushner also criticized recent protests, saying that "those provoking violence are part of the problem and not part of the solution."US ambassador to Israel, David Friedman, Deputy Secretary of State John Sullivan, Secretary of Treasury Steven Mnuchin, White House senior adviser and first daughter Ivanka Trump, and special representative for international negotiations Jason Greenblatt attended the ceremony as part of the US delegation.  2782

What makes a successful relationship? As some couples have found out during the pandemic, and researchers have scientifically discovered, it may boil down to how you engage with each other and how committed each partner is.A study published this week in the Proceedings of the National Academy of Sciences looked at responses from more than 11,000 romantic couples, tracked over about a year.“People’s own judgments about the relationship itself—such as how satisfied and committed they perceived their partners to be, and how appreciative they felt toward their partners—explained approximately 45% of their current satisfaction,” the study’s authors note. “The partner’s judgments did not add information, nor did either person’s personalities or traits.”Top relationship-specific predictors of relationship quality:Perceived partner commitmentAppreciationSexual satisfactionPerceived partner satisfactionConflictA person's own perception of their relationship accounted for about 45 percent of their current satisfaction with their relationship at the onset of a study, and about 18 percent by the end of the study.The study’s authors note the results are based on self-reporting and more study is needed over a longer period of time to see if these characteristics hold true over the long run.If you haven’t lately, it might be a good time to let your partner know that you appreciate them. 1402

White House chief of staff John Kelly says he will "absolutely not" apologize for his comments on Rep. Frederica Wilson, adding that he stands by his comments.President Donald Trump and the Florida Democratic congresswoman publicly fought over each of their accounts of the conversation the President had with the widow of a slain soldier. Following Wilson's criticism, Kelly had spoken in defense of Trump at the White House press briefing, where he also recounted his own experience from when his own son was killed in action.When defending Trump in the wake of the feud, Kelly claimed Wilson had boasted of securing " million" in federal funding to build a new FBI field office in Miami during the dedication ceremony for the building in 2015. He also called the congresswoman an empty barrel, saying her remarks focused more on her own actions than the heroism of the two FBI agents for whom the new building had been named. 939

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